Can keto or low-carb diets cure acne?

Most people follow a low-carb or keto diet expecting to lose weight, achieve better blood sugar control, and/or lower their blood pressure. In most cases, these are exactly the type of results that occur.

However, some individuals may also experience an unexpected bonus: improvement in skin quality, including a decrease in the frequency and severity of acne.

Indeed, there’s emerging evidence that this way of eating may help control acne due to its effects on hormonal health.

How does acne develop?

Although nearly 90% of adolescents and teens have acne, it’s fairly common in adults as well. In fact, it’s estimated that in Western countries, around 50% of people in their 20s and 30s struggle with acne. On the other hand, it’s very rare in many cultures who follow traditional diets.

Acne develops as a result of complex interactions that take place within the skin. Sebaceous glands located in the skin’s outer layer are connected to hair follicles. These glands produce sebum, an oily substance that lubricates the hair and skin cells, which are constantly being shed and replaced.

In the case of acne, this system is impaired. Elevated levels of androgens (male hormones) cause increased sebum production, leading to oily skin. In addition, skin cell production ramps up, and dead skin cells aren’t shed in the normal fashion. Instead, these cells combine with excess sebum, causing blocks or plugs. While this process is occurring, bacteria that feed on sebum also enter the picture.

Similar to the gut microbiome, skin maintains its own bacterial balance. One type of bacteria known as P. Acnes lives deep within the hair follicles and is normally present in the outer skin layer in small amounts. However, during acne, concentrations of P. Acnes increase dramatically, causing inflammation that leads to whiteheads, pustules and cysts.

Carbohydrates may be the main dietary culprit in acne due to their negative effects on hormonal regulation.

For instance, a 2007 controlled study in 43 young acne-prone men by Smith, et al, found that a low-glycemic-load diet led to a greater reduction in acne lesions than a higher-glycemic-load diet. What’s more, the low-glycemic-load group experienced a decrease in androgen and insulin levels, improvement in insulin sensitivity, and weight loss. By contrast, the other group had increases in weight, insulin levels, and insulin resistance.

It’s important to point out that this wasn’t really a low-carb diet; the low-glycemic-load carbs accounted for about 44% of the total dietary intake. Would there have been an even greater improvement with a low-carb or keto diet providing less than 15% of energy from carbs?

Low-carb and ketogenic diets for acne

Many people have reported that their skin has become much clearer as a result of following a low-carb or keto diet.

Although controlled research on carb restriction for acne has yet to be done, many people have reported that their skin has become much clearer as a result of following a low-carb or keto diet.

Moreover, there are logical reasons why minimizing carb intake would be helpful for acne sufferers.

In a compelling 2013 review on therapeutic uses of ketogenic diets for various conditions, Paoli, et al, state that although the emerging evidence for the use of keto diets in acne is promising, randomized controlled trials (RCTs) are needed to confirm these benefits.

Keto or low carb: Which is best for acne?

As there aren’t yet any studies on stricter low-carb or keto diets for acne at this time, it’s difficult to determine the degree of carb restriction needed to achieve the best results. Similar to losing weight or reducing blood sugar, the necessary carb reduction for potential acne control likely varies from person to person. It’s possible that stricter low-carb diets are more effective.

Tips for maximizing the benefits of a keto or low-carb diet for acne

Below are some additional dietary tweaks that may or may not be useful. They are based on preliminary evidence, small studies that need to be repeated to know for sure whether the suggested effects are real.

Consume fatty fish often:Long-chain omega-3 fatty acids found in fish are anti-inflammatory and have been credited with possibly improving acne. The best sources include salmon, mackerel, sardines, herring and anchovies.

Avoid or limit dark chocolate: Although earlier studies showed no difference in acne response when chocolate was compared to other sweets, a 2016 study found that even virtually sugar-free 99% dark chocolate might significantly worsen breakouts in acne-prone men. For this reason you may want to limit even dark chocolate intake, just to be safe.

Focus on fresh low-carb foods: Even if you don’t eat sugary and starchy foods, you may still be consuming ingredients that can cause skin issues. Bologna and other processed meats often contain sugar, corn syrup, fillers or other additives that raise insulin levels and potentially provoke inflammation. Stick to fresh food whenever possible, and read labels on processed meats and other packaged foods.

Give the diet some time: Paradoxically, some people report a worsening of acne shortly after starting a keto or low-carb diet. However, this appears to be short-lived and may be part of the keto-adapatation process. Overall, breakouts seem to improve with carb restriction long term in the vast majority of people.

Summary

While the evidence is still somewhat preliminary, there are many reasons to believe that low-carb and keto diets can improve acne. Feel free to read several stories below from people who have tried it, and to use our free guides linked below to get started.

By choosing nutrient-dense low-carb whole foods that minimize insulin levels and reduce inflammation, you may be giving yourself the best shot at clearer, healthier skin.

Trying a low-carb diet is safe, and besides the cost of buying real food, it’s also free. So why not try it out for a few weeks, and see what happens to your skin?

Have you already tried a low-carb or keto diet for acne? Feel free to leave a comment below, and share your experiences.

Try it

Low-carb basics

Keto for beginners: Introduction08:02Learn how to do a keto diet right, in part 1 of our video course.

My success story with Katrin Crum02:45Katrin was diagnosed as being morbidly obese, and was suffering from a number of health issues. She had tried a lot of different diets over the years but nothing had worked long term.

The 5 common mistakes on LCHF09:25Is it hard to reach your goal weight, are you hungry or do you feel bad? Make sure you're avoiding these mistakes.

Living low carb with Jill Rieder: Finding her way to health08:32Meet Jill Reider and get to know all about her experiences on a keto diet.

My success story with Carole Freeman02:58Carole’s list of health issues had been growing longer and longer over the years, up to the point when it just got to be too much. Check out the video above for her full story!

Pie-making champion goes low carb03:23Learn how this pie-making champion went low carb and how it changed his life.

Cereal Killers1:00:07What if you could – in fact – break records without eating massive amounts of carbs?

My success story with Mitzi Champion02:41Mitzi is a 54-year-old mother and grandmother who has been following the low carb/keto lifestyle more than two-and-a-half years. This is a journey and lifestyle, not a temporary quick fix!

7 tips to make low carb simple09:41The star of the BBC series Doctor in the House, Dr. Rangan Chatterjee, gives you seven tips that will make low carb easy.

My success story with Chuck Hicks02:39At nearly 500 lbs (230 kg) Chuck could barely move at all anymore. It wasn’t until he found a keto diet that thing started to change.

A global food revolution34:30The mistakes behind the obesity epidemic and how we can fix them together, empowering people everywhere to revolutionize their health.

Women's questions introduction01:36In this video series, you can find expert views on some of your top questions about low-carb and women's health.

Carb-Loaded1:14:40This may be the best (and funniest) low-carb movie ever. At least it's a strong contender.

How to stay low carb on a budget02:36Do you want to know how to stay low carb on a budget? Kim Gajraj interviews Dr. Eric Westman to get all of his best tips on how to keep costs low when on a low-carb diet.

The cause of obesity38:45What is the real cause of obesity? What causes weight gain? Dr. Jason Fung at Low Carb Vail 2016.

My success story with Kenneth Russell02:52When Kenneth turned 50, he realized that he wouldn't make it to 60 the way he was going.

How to formulate a low-carb keto diet48:32Low-carb pioneer Dr. Eric Westman talks about how to formulate an LCHF diet, low carb for different medical conditions and common pitfalls among others.

"I sort of wanted to save the world"22:22How can you give back to the low-carb community after achieving great results on the diet? Bitte Kempe-Björkman explains.

Everything in moderation?05:44What’s the point of low carb, shouldn’t we all just try to eat everything in moderation? Top low-carb doctors answer this question.

Q&A with Franziska Spritzler09:52Questions about how to formulate an optimal low-carb or keto diet.

Living low carb with Caroline Smale07:30Caroline Smale shares her low-carb story and how she lives low carb on a daily basis.

How to eat LCHF11:18Dr. Eenfeldt on what you need to know to start eating a low-carb, high-fat diet.

My Big Fat Diet42:31What would happen if an entire town of First Nation people went back to eating the way they used to? A high-fat low-carb diet based on real food?

Teaching low carb to patients in the Middle East05:44How do you help patients in the Middle East to start a low-carb diet?

Why is low carb important to you?04:16Why is low carb important to Dr. Rangan Chatterjee and Dr. Sarah Hallberg?

Low carb explained32:06Almost no one knows more about the practicalities of low carb than Dr. Mary Vernon. Here she explains it for you.

"A more pleasurable way to live"10:51Franziska Spritzler talks about what turned her into a low-carb dietitian.

The latest science behind a keto diet13:17What is the current science in support of a low-carb and keto diet?

Are there potential dangers with a low-carb diet?09:30Can a low-carb diet potentially be dangerous? And if so – how? Top low-carb doctors answer these questions.

What is the main benefit of low carb?02:52What exactly is the greatest benefit of low carb? Doctors give their top answer.

Earlier

Comments

14 comments

I can attest to LCHF improving my acne. Used to get lots of cyctic acne around my period. Since being on LCHF, it has vastly improved. Not quite 100%, but I no longer see it as a problem or ashamed by it.

Apart from better skin, LCHF is the best thing I ever could have done for many reasons. My only regret is that I didn't start it sooner.

What about hair loss, specifically androgenic alopecia which is linked to elevated androgens or a sensitivity to a normal amount of androgens? I am a woman and have been suffering from this for the past few years. I have lost 70% of my hair and my hair no longer grows at all anywhere. My hairline and temples are the hardest hit and the hairs are stunted and stuck at various short lengths, like 1/2 inch to 2 inches. This has been devastating. I have been trying to do low carb but the stress over my hair puts me in a constant sugar binge eating cycle. I have seen articles that show a connection between insulin resistance and inflammation from a high sugar and wheat diet and androgenic alopecia. But I haven't seen any definitive articles about sugar being the cause, just a contributor to a problem that is genetic. I saw one article that was pretty bleak and it said that once the damage to the hair is done, nothing can reverse it. The article suggested a possible prevention of future hair loss but stated that regrowth was not possible. I don't have celiac or hashimotos so I don't believe that its a reaction to gluten. I have seen a few specialists and will be starting an anti androgen program but I would love to know if anyone has reversed androgenic alopecia with a low carb diet or if there is any new research about this.

BTW, I did suffer with acne as a teenager but it was not extreme. I have been on a high sugar overeating diet my whole life. But just my hair is suffering, I have seen no increase in acne. I don't understand why my hair would be so terribly affected while my skin has not been.

Just wanted to add that I routinely hear that low carb diets CAUSE hair loss so it scares me that I might lose even more hair if I go low carb. I have gone low carb twice in the past for short periods of time, one month and ten weeks. I was suffering from the hair loss and non growing hair before starting. But the stories about people losing tons of hair from low carb as well as from fasting are really frightening for someone in my situation.

I just visited my dermatologist who commented on how hydrated and healthy my skin is, for someone my age (late middle). I used to have dry skin, got rashes, and with a low carb sometimes keto diet, and normal moisturizing, my skin has very few wrinkles. And my fine hair has never been healthier. I'm convinced diet is important to the health of our largest organ, the skin.

58 and have mild life long acne. 6 weeks of keto, intermitent fasting, and my acne disappeared, lost 15 pounds so far and I swear my wrinkles are less. skin feels smooth, looks cleaner, bags under eyes and bruised look below eyes dissapaiting. Back pain better. lost 3 inches on waist. i will credit keto with the acne although I'm guessing wheat is a big part of that.

Strictly followed a Keto diet for 16 weeks. Lost 20 lbs, plus the big surprise... My skin was the clearest it’s been in my adult life...went from some adult facial acne and bad scalp eczema even with use of expensive prescriptions to completely clear skin to ...no acne, no eczema... to the point I forgot where I put the prescription bottles because I no longer needed them ! Started really noticing a difference about 4weeks into diet.

LCHF did not cure my acne, so, I tried going gluten free and it worked. Seems I had Dermatitis herpetiformis, as in, coeliac decease with symptoms on the skin. According to Wikipedia: "Estimates of DH prevalence vary from 1 in 400 to 1 in 10,000. It is most common in patients of northern European/northern Indian ancestry, and is associated with the human leukocyte antigen (HLA) haplotype HLA-DQ2 along with coeliac disease and gluten sensitivity."

I have suffered from quite severe acne for 37 years (I am 49). I tried everything, but nothing worked. After starting the ketogenic diet for completely different reasons, to my surprise my acne disappeared within four weeks. I have now been almost completely acne free for nine months. The only instances I will have a flare up is when I cheat and have anything containing wheat, even if it is only a tiny bit, such as wheat protein in a veggie burger.

I follow a ketogenic diet with zero grains because gluten causes me breakouts, but the worst for my skin now is dairy. The thing is, the dairy didn't become an issue until about age 59-60 (61 now), so one never knows when the body will finally say, "enough". For a little while, I could get away with having some aged cheddar, but even that causes very inflamed pustules to break out on my cheeks and forehead (never on my chin or nose, for some reason). I eliminated the cheese and my skin cleared up. I tried a small piece after about 2 weeks and it was ok, but when I tried another small slice a few days later, the pustules returned, so now I either have to steer away from all dairy for good, or at most have a sliver once every week or two...It sucks, but the health benefits and skin's appearance while on a ketogenic diet far outweigh the little sacrifices.

Acne has never been a significant problem for me, but I started to get rosacea a few years ago, a common for someone who is very fair skinned as they age. I have been eating low carb for over 2 years now. It took some time, but I think the redness has improved greatly. As there is not a very good medical treatment for it, this was a pleasant surprise.

Has anyone had a reaction when starting Keto. I’ve been on keto for 4 weeks and have very dry red itchy hot face. Not sure what this is from? Has anyone experienced this on Keto. Could be a coincidence.

Hi Jill, this sounds horrible! I’m so sorry you’ve been going through this. I used a ketogenic diet to fix my acne/hormones. I know that eating lot of carbs, simple ones like sugar and refined grains drive up insulin very quickly. Insulin itself is a hormone that effects how you use glucose for energy or store glucose as fat. In addition to this it will drive up and down other hormones. Resistance to insulin is like resistance to any hormone or drug ( think cortisol or alcohol.) Something else to bare in mind is if your insulin is high you can’t access your fat for energy. So if you can’t get your energy from fat and your resistant to receiving energy from insulin/glucose, certain cells that have resistance to insulin will start to die or misfuction. That’s why diabetics have so many symptoms that you don’t see anywhere else, such as ganggreen. I know it’s hard but you need to stop bingeing on sugar. Every time you do your staving your body by denying it a source of energy. I don’t know if you can grow your hair back, I personally think it’s possible, but you need to be very strict with keto and you may not see things start to clear up for months. Look at it this way, you been loosing your hair on a high carb and you been trying this diet for probably most of your life. You should give keto a few months to prove its effectiveness.

Just wanted to add that I routinely hear that low carb diets CAUSE hair loss so it scares me that I might lose even more hair if I go low carb. I have gone low carb twice in the past for short periods of time, one month and ten weeks. I was suffering from the hair loss and non growing hair before starting. But the stories about people losing tons of hair from low carb as well as from fasting are really frightening for someone in my situation.

I have been on LCHF since February 20, 2019 and just this past week I have been experiencing breakouts on my skin...It started on my forehead as fine red dots...now on my lower chin...Before this my skin had been clear since my 20s...(I'm now in my late 50s)...What can this be? I stay hydrated...I have been down to 20 to 25 carbs per day...I am not putting meds on my skin...Just waiting to see what is going on...Just wondering if others have experienced this?